Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2016 Jul;155(1):22-7.
doi: 10.1177/0194599815627641.

Thyroid Disease and Surgery in CHEER: The Nation's Otolaryngology-Head and Neck Surgery Practice-Based Network

Kourosh Parham  1 , Nikita Chapurin  2 , Kris Schulz  2 , Jennifer J Shin  3 , Melissa A Pynnonen  4 , David L Witsell  2 , Alan Langman  5 , Anh Nguyen-Huynh  6 , Sheila E Ryan  2 , Andrea Vambutas  7 , Anne Wolfley  8 , Rhonda Roberts  8 , Walter T Lee  9
Affiliations
Multicenter Study

Thyroid Disease and Surgery in CHEER: The Nation's Otolaryngology-Head and Neck Surgery Practice-Based Network

Kourosh Parham et al. Otolaryngol Head Neck Surg. 2016 Jul.

Abstract

Objectives: (1) Describe thyroid-related diagnoses and procedures in Creating Healthcare Excellence through Education and Research (CHEER) across academic and community sites. (2) Compare management of malignant thyroid disease across these sites. (3) Provide practice-based data related to flexible laryngoscopy vocal fold assessment before and after thyroid surgery based on the American Academy of Otolaryngology-Head and Neck Surgery Foundation's clinical practice guidelines.

Study design: Review of retrospective data collection (RDC) database of the CHEER network using ICD-9 and CPT codes related to thyroid conditions.

Setting: Multisite practice-based network.

Subjects and methods: There were 3807 thyroid patients (1392 malignant, 2415 benign) with 10,160 unique visits identified from 1 year of patient data in the RDC. Analysis was performed for identified cohort of patients using demographics, site characteristics, and diagnostic and procedural distribution.

Results: Mean number of patients with thyroid disease per site was 238 (range, 23-715). In community practices, 19% of patients with thyroid disease had cancer versus 45% in the academic setting (P < .001). While academic sites manage more cancer patients, community sites are also surgically treating thyroid cancer and performed more procedures per cancer patient (4.2 vs 3.5, P < .001). Vocal fold function was assessed by flexible laryngoscopy in 34.0% of preoperative patients and in 3.7% postoperatively.

Conclusion: This is the first overview of malignant and benign thyroid disease through CHEER. It shows how the RDC can be used alone and with national guidelines to inform of clinical practice patterns in academic and community sites. This demonstrates the potential for future thyroid-related studies utilizing the otolaryngology-head and neck surgery practice-based research network.

Keywords: CHEER; academic; cancer; clinical practice guidelines; community; flexible laryngoscopy; practice-based research network; thyroid disease; thyroid surgery; thyroidectomy; vocal cord function.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Depicts volume of thyroid disease at each individual site, including site-specific proportion of malignant disease and practice setting (A-academic and C-community). Only practices with >= 20 thyroid patients.
See this image and copyright information in PMC

References

    1. Heintzman J, Gold R, Krist A, et al. Practice-based research networks (PBRNs) are promising laboratories for conducting dissemination and implementation research. J Am Board Fam Med. 2014;27:759–62. - PMC - PubMed
    1. Lindbloom EJ, Ewigman BG, Hickner JM. Practice-based research networks: the laboratories of primary care research. Med Care. 2004;42(4 Suppl):III45–9. - PubMed
    1. Tucci DL, Schulz K, Witsell DL. Building a National Research Network for Clinical Investigations in Otology & Neurotology. Otol Neurotol. 2010;31:190–5. - PMC - PubMed
    1. Witsell DL, Rauch SD, Tucci DL, et al. The Otology Data Collection project: report from the CHEER network. Otolaryngol Head Neck Surg. 2011;145:572–80. - PMC - PubMed
    1. Witsell DL, Schulz KA, Moore K, Tucci DL CHEER Investigators. Implementation and testing of research infrastructure for practice-based research in hearing and communication disorders. Otolaryngol Head Neck Surg. 2011;145:565–71. - PMC - PubMed

Publication types